Pressures on prisons mean importance of social care gets lost

One of the less talked about changes brought in by the Care Act 2014 is the duty it places on councils to assess and meet the social care needs of adults in prison.

It’s the first time there’s been a clear responsibility for meeting these needs, but in a survey of councils published by the Local Government Association in June last year, 13% said the legislation had not improved care and support for prisoners.

Social worker Sarah Hughes has 25 years’ experience working in mental health and criminal justice, including a stint managing a service at HMP Holloway – once Europe’s largest female prison. She’s just taken up post as the chief executive of the Centre for Mental Health, where she’ll take a close interest in mental health support in prisons.

Hughes says the “clash with austerity” has impacted councils’ ability to implement the new Care Act duty, but there are also still grey areas in terms of what it means in practice.

“You might have a local authority that runs alongside a particular prison, but it could be that 75% of the prisoners that are in there don’t actually come from that area.

“Is that local authority responsible? If they rehouse a person, who do they negotiate funding with? The legislation is absolutely critical, but there’s all sorts of obstacles.”

The importance of social care, she says, often gets completely lost because of the “immediate reactive needs” of the prison environment.

“We know that social care is vital to resettlement, reducing reoffending and breaking the cycle of despair, but those principles can’t be a priority because the staffing and resources aren’t there – so the priorities are given to damage control within the prison.

“That means keeping people as safe as possible under the day-to-day circumstances.”

‘Rapid deterioration’

Hughes joined Holloway in 2001 after a long stint working for mental health charities.

She managed the prison’s First Night in Custody service, which worked to reduce the likelihood of vulnerable women harming themselves during the first 72 hours inside.

Hughes and her staff worked with the women to gain an in-depth understanding of their lives outside of prison and gauge their risk of suicide, self-harm and domestic violence.

“It was an amazing service, but incredibly difficult and painful,” Hughes recalls.

“I will never forget the feeling of sending those women out from prison – where they’d been fed, clothed and clean – back into the same situation they’d come from.

“They would be back with us a few weeks later in the same clothes, in a terrible state.”

Many of the women used to tell her prison was the only place they felt “remotely safe”, but Hughes questions whether that would still be the case today. “If you’ve watched BBC Panorama recently, you might think differently – it’s deteriorating rapidly.”

‘Perfect storm’

Hughes is referring to the recent news reports on the crisis in UK prisons. In February, a Panorama programme exposed the high levels of drug and drink consumption at a Category C prison, and how prison officers were at risk and unable to maintain control.

It also found “little evidence” of rehabilitation or change, with weak prisoners suffering.

Ministry of Justice figures published at the end of 2016 show prison suicides reached a record high of 119 – a 32% increase on the previous year. Self-harm incidents also rose by 23%, violence between inmates by 28% and assaults on staff by 40%.

“It’s a perfect storm. These are not new issues, but what we have is an accumulation of really difficult things – a drop in prison officers, a growing prison population, and more prisoners with profoundly complex needs such as addiction and mental health,” says Hughes.

“This is coupled with the fact that prison officers simply don’t have the training and support they need – they are not enabled to have the conversation with an individual that could save their life or change the direction of self-harming behaviour.”

The government’s pledge to recruit an extra 2,500 prison officers is “absolutely a start” in tackling the issues, Hughes adds, but it’s not enough in itself.

“We need to think more about the specific mental health needs of prisoners and the specific issues in relation to trauma – social workers are critical to that,” she adds.

“A good integrated mental health team in prison makes all the difference.”

‘Tip the balance’

However, to make a difference in terms of reoffending, then there needs to be shift in the culture in prisons – and this is where social care is vital, Hughes says.

“We forget that these people are coming back to communities, they are parts of families – so if we could break that cycle, the impact on our society would be huge.

“Social care is the only possible solution route we have at the moment, yet we can’t seem to get a grip on it. Until we tip the balance in prisons, integrate social workers in a particular way and really think about their roles in terms of education and resettlement, then we are in trouble.”